Fact Sheet
Workplace Bullying in Health
Sector
Health sectors bring a significant positive effect on society by promoting individual
and public health and also contribute to economic growth and development (ILO, n.d).
Thus, in order to deliver excellent health care, health workers need decent work in the
sense that their work needs to provide security and social protection in the workplace
(ILO, n.d). However, evidence (Ariza-Montes et al., 2013; Rutherford & Rissel, 2004)
reported that many health workers are exposed to bullying behavior, either as victims or
perpetrators.
What is Workplace Bullying?
Workplace bullying is a serious issue in occupational health and safety
that has long-term effects on victims, organisations, and perpetrators.
Bullying in the workplace is even hard to recognize and manage for its
complicated and lack of consistent definition (Rutherford & Rissel, 2004). Most
people define bullying interchangeably with harassment (ACAS, 2014) or
internal violence (Rutherford & Rissel, 2004), and many include bullying as a
form of harassment (ACAS, 2014). Nevertheless, most definitions of bullying
are concern about the negative effect experienced by the victim (Rutherford
& Rissel, 2004), which characterised as offensive, intimidating, malicious or
insulting behaviour, abuse or misuse of power through means that undermine,
humiliate, denigrate or injure the recipient. (ACAS, 2014).
Comprehensive definition of workplace
bullying is a negative act that repeated and
persistent towards one or more individuals,
involving a perceived power imbalance and
creates a hostile work environment (Salin,
2003). Bullying and harassment are not always
in a face to face action form; they may also
Image taken from pinterest.com
occur in written communications, email, and
phone. (ACAS, 2014)
How common does the workplace bullying occurred in health sector?
There is no unequivocal prevalence of bullying due to its broad definition
(Rutherford & Rissel, 2004). However, a study by Rutherford & Rissel (2004)
in a health sector organisation found out that 50% of the employee had
experienced one or more forms of bullying behavior in the last 12 months
while employed within the organisation. Intimidating behavior, such as
belittling, sneering, shouting, or ordering (32%) is the most common bullying
behavior experienced by the respondents, followed by tones of voice or facial
expressions that leave you feeling put down (26%). More specific data on the
working period of the respondents who engaged in bullying and the source of
bullying are explained by the charts below.
Working period
Source of Bullying
8%
29%
50%
49%
38%
63%
42%
53%
Peers
Clients
less than 12 months
1-2 years
Manager/supervisor
2-5 years
more than 5 years
Staff managed by the respondent
In addition, another study by Ariza, et al. (2013) shows that the chance
of a healthcare worker exposed to bullying behavior increases among worker
who works on a shift schedule, perform monotonous and rotating tasks, suffer
from work stress, enjoy little satisfaction from their working conditions, and
do not perceive opportunities for promotions in their organisations.
Why do people bully and get bullied?
Bullying does not occur independently but is rather a multi-causal
phenomenon (Salin, 2003; Rutherford & Rissel, 2004). Individual personality
and traits, both in victims and perpetrators, are factors that might trigger the
occurrence of workplace bullying. Another study also focuses on the structural
characteristics of organisation on people instead of the individual factors. In
fact, individual and organisational factors are influencing each other in the
sense that individual might tend to aggressive in certain environments and so
does the environment may be affected by a certain aggressive individual
(Salin, 2003).
Salin (2003) stated that basically, the causes of workplace bullying are
because there is a certain condition that enables the behavior to occurred and
factor that is motivating it. Those enabling conditions are :
•
A perceived power imbalance between the victims and perpetrator: the
conditions where the victims have a sense of helplessness and a
defenceless position. Otherwise, a person who can withstand the
aggressiveness and retaliate might prevent the bully from happening at
the beginning.
•
Low perceived cost: The cost, in the sense of the risk for the bully such
as reprimand, being dismissed, socially isolated, or punished, is low.
•
Dissatisfaction and frustration: The dissatisfaction and frustration
toward the work environment, organisational climate, and internal
communication is the starting point for aggression at work. This includes
organizational constraints and a lack of control over one’s own job, lack
of clear goals, and role conflict and ambiguity.
In addition, the motivating factors are circumstances where it might
actually be rational for a person to bully someone. Such motivational factors
include high internal competition, certain forms of reward systems such as
promoting an employee who has succeeded surpass their colleagues by
violating them, and expected benefits for the perpetrator.
What are the consequences or impact of this problem?
Workplace bullying can bring a detrimental effect on organisation, since
it influences the individual negatively in multi-aspects. The result of being
bullied is a feeling of stressed or depressed, feeling angry, helpless or fearful,
and avoidance behaviour (Leka & Hodmount, 2010; Rutherford & Rissel,
2004). The stress experience usually enhances the consequences of workplace
bullying which result in work withdrawal behaviours (absenteeism and sick
leave), poor psychological health (anxiety, depression, and victimization), and
poor physical health (sleep problems, fatigue, and colds) (Leka & Hodmount,
2010).
Individual outcomes such as performance and team productivity will be
reduced as well as a result of being bullied. Sexual harassment, one of a form
of workplace bullying, positively related to team conflict (Leka & Hodmount,
2010). Teams who reported higher levels of harassment experienced more
conflict, reduced cohesion, and reduced performance. In addition, not only the
victims of bully behavior that are affected negatively by bullying but also the
worker who witnesses the harassment reported a decrease in their own
performance level (Leka & Hodmount, 2010).
Supporting evidence that shows the impact of workplace bullying in
health sector organisation is proposed by Rutherford & Rissel (2014). The
result of being bullied are as followed:
Result of being bullied
13%
10%
7%
Feeling stressed or depressed
70%
35%
Feeling angry, helpless or
fearful
Considering looking for
alternative employment
Being reluctant to attend
work
Feeling ill
35%
Changing work practices
61%
Figure above confirms that there are several impacts of workplace
bullying to worker’s mental health (stressed, depressed, angry, helpless,
fearful), physical health (feeling ill), and also to their performance
(considering looking for alternative employment, being reluctant to attend
work, and changing work practices). Although the effect on their performance
categories is relatively low compared to their mental health, the feeling of
stress and depressed may interfere in another form of working performance,
such as unable to focus on job, lack of energy, and difficulties to socialise with
others, which result in the inability to perform well on work. In this respect,
the negative effect of workplace bullying is worth noting for a total of 70% of
respondents are acknowledge the feeling of stress and depressed.
Preventing Workplace Bullying
In
preventing
workplace
bullying,
an
appropriate
and
rigorous
intervention should be implemented. Regarding on the antecedents of
bullying, the organisational social environment is the dependent factors that
enable and motivate bullying behaviour to occur. Therefore, it is come to a
concern to design a supportive work environment in the organisation.
A high level of support will have direct positive effects on reduced stress
and increased well-being (Leka & Hodmount, 2010). Evidence suggests that a
supportive work environment may act as a coping strategy, as well as
moderating and buffering the damage effects of work stressors such as
bullying (Rutherford & Rissel, 2004). The job Demand-Control-Support (DCS)
model also proposed that social support from colleagues, supervisors, or other
people can act as moderating variable in the relationship between stressor
and well-being (Leka & Hodmount, 2010).
Given the fact that mostly bully comes from peer groups, it is best to
schedule an organized group activity such as team-building exercises to
enhance their positive interaction together so that a more supportive
atmosphere can be maintained. In order to avoid the sense of competitiveness
among teams, groups should be assembled randomly in each session. In this
respect, supervisors and subordinates might also team up together if
appropriate. So that vertical relationships among workers can also be
enhanced.
Monitoring and evaluating the group activity is a vital part that comes
after it. Evaluation informs the effectiveness of the intervention, whether any
changes should be made. Workers should reflect their feeling and experience
of the activity, to clearly understand the social dynamic inside the group. In
addition, reassessment of the problem, which in this case is workplace
bullying, should also be conducted to give precise data on the occurrence of
bullying behaviour.
Key policy and legal documents
The Equality Act 2010 legally protects worker from harassment at the
workplace. The harassment includes unwanted behaviour related to a relevant
protected characteristic, which has the purpose or effect of violating an
individual’s dignity or creating an intimidating, hostile, degrading, humiliating
or offensive environment for that individual (ACAS, 2014). If the unwanted
behaviour as listed earlier is experienced by the worker, it is against the law
so that complaints can be made.
Employer should bear in mind that they are responsible for preventing
bullying behaviour and harassment. Such behaviour will not be tolerated since
it brings detrimental effect on both the individual and the organisation. There
should be any statement to all staff about the standards of behaviour
expected, so that the individuals are easier to be fully aware of their
responsibilities to others (ACAS, 2014).
Conclusion
Workplace
bullying
in
the
health
sector
should
be
taken
into
consideration, as evidence suggests high exposure to bullying in health
organisations. Organisation should be aware of the detrimental impact of
workplace bullying on worker’s health and performance. Therefore, an
appropriate and rigorous intervention should be implemented to address the
issue, as well as highlighting the key policy regarding this issue to the
employees.
References
ACAS
(2014).
Bullying
and
Harassment
at
Work.
Retrieved
from
https://www.acas.org.uk/media/306/Advice-leaflet---Bullying-andharassment-at-work-a-guide-for-employees/pdf/Bullying-andharassment-at-work-a-guide-for-employees.pdf
Ariza-Montes, A., Muniz, N., Montero-Simó, M., & Araque-Padilla, R. (2013).
Workplace bullying among healthcare workers. International journal of
environmental
research
and
public
health,
10(8),
3121-3139.
https://doi.org/10.3390/ijerph10083121
ILO. (n.d.). Health services sector. Retrieved January 2, 2020, from
https://www.ilo.org/global/industries-and-sectors/healthservices/lang--en/index.htm.
Leka, S. E., & Houdmont, J. E. (2010). Occupational health psychology. WileyBlackwell.
Rutherford, A., & Rissel, C. (2004). A survey of workplace bullying in a health
sector
organisation.
Australian
Health
Review,
28(1),
65-72.
https://doi.org/10.1071/AH040065
Salin, D. (2003). Ways of explaining workplace bullying: A review of enabling,
motivating and precipitating structures and processes in the work
environment. Human relations, 56(10), 1213-1232.